Health surveillance is a program of repeated health assessments for workers who remain exposed to a workplace hazard after controls are in place, used to identify ill health caused by work. Great Britain’s Health and Safety Executive (HSE) defines it as “a scheme of repeated health checks which are used to identify ill health caused by work.” HSE names noise, vibration and substances hazardous to health among the risks that require it.

What the regulations say

Great Britain.

  • Regulation 6 of the Management of Health and Safety at Work Regulations 1999 requires every employer to provide “such health surveillance as is appropriate having regard to the risks to their health and safety which are identified by the assessment.”
  • Regulation 11 of the Control of Substances Hazardous to Health Regulations 2002 (COSHH) treats health surveillance as appropriate where an identifiable disease or adverse health effect may be linked to the exposure, is reasonably likely in the conditions of the work, and can be detected by a valid, low-risk technique. Where a worker is exposed to a substance listed in Schedule 6 and works in a process listed there, it must include medical surveillance under the supervision of a relevant doctor at intervals of not more than 12 months, or shorter if the doctor requires.

COSHH also requires a health record for each worker under health surveillance, kept for at least 40 years from the last entry (see how long to keep occupational health records), and workers must be given access to their own record on reasonable notice. HSE adds that the law requires medical surveillance by an HSE appointed doctor for certain hazards, such as asbestos, lead and ionizing radiation, with an exception for some lower-risk asbestos work.

European Union. Article 14 of Framework Directive 89/391/EEC requires national measures so that workers receive health surveillance appropriate to the risks they incur at work, and so that each worker can, if they wish, receive it at regular intervals. It may be provided as part of a national health system.

United States. OSHA addresses medical screening and medical surveillance in specific standards.

How it works in practice

  • Get competent input. HSE says schemes should usually be set up with input from a competent occupational health professional.
  • Act on the results. When health surveillance finds a disease or adverse effect considered to result from exposure, COSHH regulation 11(9) requires the employer to ensure the worker is informed, review the risk assessment and controls, consider alternative work, and review the health of others similarly exposed.
  • Keep it distinct. HSE stresses that health surveillance “is not the same as health monitoring, health promotion or health screening.”

Why it matters for employers

HSE’s reason is simple: control measures “may not always be reliable, despite appropriate checking, training and maintenance.” Health surveillance provides feedback on the actions needed to prevent further harm and lets workers raise concerns about how work affects their health.

In MyC’s health surveillance software, surveillance is scheduled per worker from their exposure group, with due dates and expiry alerts.

  • Medical surveillance: Medical surveillance is the program of medical exams and tests that specific OSHA standards require employers to offer workers exposed to certain hazards.
  • COSHH health record: A COSHH health record is the record COSHH requires in Great Britain for each worker under health surveillance, kept at least 40 years from the last entry.
  • Similar exposure group (SEG): A similar exposure group (SEG) is a group of workers expected to share the same exposure profile, used to plan monitoring and read surveillance results.
  • Fitness-to-work: Fitness-to-work is an assessment of whether a worker's health lets them do a specific job safely, without danger to their own health or that of others.

Go further

Sources

  1. Health surveillance: overview (HSE)
  2. Management of Health and Safety at Work Regulations 1999, regulation 6: Health surveillance (legislation.gov.uk)
  3. Control of Substances Hazardous to Health Regulations 2002, regulation 11: Health surveillance (legislation.gov.uk)
  4. Council Directive 89/391/EEC: Framework Directive on safety and health at work, Article 14 (EUR-Lex)
  5. Medical Screening and Surveillance: Overview (OSHA)

Written by Lisa Bardet, VP Marketing at MyC. Every factual claim in this entry is checked against the primary sources listed above before publication.

This entry is general information for employers and occupational health teams. It is not legal or medical advice for a specific situation.